THE JOB HUNT

Time to look for jobs :P

As the year came to an end we began getting introduced to different job opportunities. It was beginning to feel strange as employers are coming to us. We were given free pizza lunches (good brand name pizza), we had a nice outing to look at rural opportunities and we got good schwag from them :)

Our field trip to rural Manitoba

 At the beginning of the summer we were given a booklet of job opportunities available in the province. There were a few in the city and a lot rurally. The applications were in and I began going to interview after interview. It was strange to be competing with your fellow classmates/friends and I admit there were times where I wanted to give up as most opportunities weren’t offered to me at first. It’s hard to determine what employers are looking for.

Free coffee!!! yey

I am excited to say that I have accepted a position in internal/hospitalist medicine in rural Manitoba. It will be a long commute 45-60 min (depending on traffic) one way but the position is what I am looking for. I am hoping to get good teaching and to continue writing about my experience in my first year working as a physician assistant. 

Have two weeks off. Start my position Sept. 15 :P -

ELECTIVE #2 - OCCUPATIONAL MEDICINE

For my last rotation I went to a diamond mine to see what occupation medicine is all about. In the mine the only medical provider are PAs. It sounds exciting that PAs are able to provide medical care in remote areas. These PAs have had years of experience in emergency medicine and are fully capable to treat patients with the common cold to trauma accidents, heart attacks and strokes 

TYPICAL DAY

6:30 am – 10:00 am – OPEN CLINIC – patients walk in similar to a walk in clinic. I saw mainly things you would see in a family office. One of the biggest differences is since there are no nurses or pharmacists you need to be all those roles. This includes placing IVs if needed and counting, labeling and bottling prescriptions that you've prescribed.The PA also has appointments for audiology and spirometry testing for all employees. 

10:00am – 12:00pm – PAPERWORK/HEALTH PROMOTION – the PA has tons of occupational health related paperwork such as workers comp etc. We also did wellness promotion with surveys on wellness.

I had ice cream everyday :P

12:00pm – 1:00pm – LUNCH – all I can say is ALL YOU CAN EAT 24hrs breakfast/lunch/dinner/snacks (and yes a self-service ice cream bar)

Best pastries ever!

1:00pm – 3:30pm – PAPERWORK/HEALTH PROMOTION

3:30pm – 6:30pm – OPEN CLINIC

Days were long especially when there were not many patients coming in. There weren’t many workplace accidents as you would think and no life threatening emergencies that I saw. The mine places a great importance in safety. I did get some awesome one on one teaching with the PA that works there. They have all the training equipment that you need especially for emergency medicine. I didn’t have to fight for it with the med students or my fellow classmates :P

I was taken out to tours of the pits. This was crazy. I didn’t realize how much is required to run a mine. There are always employees working 24 hours in the day. I didn’t get to see much wildlife. I did see some caribou and siksik (artic ground squirrel).

My steel toed shoes were one size to big for me :P 

WHAT I SAW

Pharyngitis

Pneumonia

Finger lacerations

Closed fibula fracture – had to send to the closest city for an x-ray

Syncope

Cornea abrasions – yes they have their own slit lamp

One diamond :P 

The only diamond I saw - displayed in a case. This was found during there first exploration digging.

Yes there were other activities offered in the camp. They had a gym open 24 hours as well as exercise rooms. I participated in yoga, basketball games and movie nights.

What made this rotation awesome was the PAs. Working with PA preceptors are great as you are able to see their full scope of practice and learn a lot from them.

Here are some more pictures from my adventure. 

ELECTIVE #1: PLASTIC SURGERY

I wanted to have more opportunity to suture so I chose plastics surgery as one of my electives. Plastics surgery currently has PAs working for them. This was a great opportunity to witness how PAs function in surgery.

A normal day 

7:00am – meet with the PAs and determine the OR slate for the day 

7:30am – head to the OR and help assist the OR nurses set up the equipment needed for surgery 

8:00am – 5pm – OR assist – It was difficult to do much in the OR as there were plenty of residents to assist. I did get some good suturing practice. Practiced some dermal and running stitches

CLINICS: These were fun. They were quick visits and I was able to see the outcomes of the surgical procedures that were done. 

WHAT I SAW

- Mastectomy and breast reconstruction DIEP method – using abdominal fat to reconstruct the breast and the patient got a free tummy tuck :P. This was amazing. 

- Breast lift

- Liposuction

- Scar revision

- Traumatic hand reconstruction

- Flaps 

- Latissimus dorsi breast reconstruction 

- Carpal tunnel

- Dupuytren contracture

Plastic surgery had more possibilities and depth than I knew coming in. My perceptions of plastic surgery was what I've seen on TV ie. greys anatomy and celebrities. I did not see any cosmetic surgery on this rotation. Most cases were cancer patients that were getting their cancer surgically removed. Plastics was responsible for fixing the area and making it functional. Microsurgery was awe-striking. I never knew such surgery existed. You can literally take any part of your body and attach it somewhere else on your body. Plastic surgery are for those who are detailed orientated as it requires a lot of time and patience to attach small arteries, veins and ligaments.

Picture I found on the internet- microsurgery

I was amazed at what the PAs got to do. One PA who has been working for only 2 years was cutting, suturing on their own and was well respected by the residents. I could see the trust the surgeons have with the PAs. They prefer the PA in assisting in certain cases especially the PAs who have been working there for years. The PAs truly function as physician extenders. Here they were like residents that never leave. I recommend this elective for those who are interested in surgery. I admit it was difficult standing for more than 2 hours, my hips would start acting up :P . Some cases we would stand even up to 7 hours. 

This was a great rotation with awesome PA mentors.